{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:57:14Z","timestamp":1764172634371,"version":"3.40.5"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The underlying causes of failure or recurrence after ligation of the intersphincteric fistula tract are postulated to be refistulization, breakdown of the closure wound in the intersphincteric plane and faecal contents entering the internal opening, thereby causing recurrent infection. The aim of this study is to demonstrate the outcomes of subtotal fistulectomy with sliding anoderm flaps to prevent refistulization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This retrospective study used prospectively collected data. Patients with transsphincteric or intersphincteric fistulas were enrolled between August 2021 and July 2023. An anal manometric study was performed before and after surgery. Faecal incontinence was evaluated using the faecal incontinence severity index (FISI). Failure was defined as nonhealing of the surgical wound or fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010one patients who underwent subtotal fistulectomy with a sliding anoderm flap were included. After a median follow\u2010up of 12\u2009months (range 4\u201327\u2009months), primary healing was achieved in 49 patients (96%). Two patients experienced treatment failure, while none developed postoperative recurrence. The median healing time was 10\u2009weeks (range 6\u201324\u2009weeks). The FISI scores did not change significantly after the surgery. The median resting pressure significantly reduced after surgery [125\u2009cmH<jats:sub>2<\/jats:sub>O (range 59\u2013204\u2009cmH<jats:sub>2<\/jats:sub>O) vs. 99\u2009cmH<jats:sub>2<\/jats:sub>O (range 36\u2013176\u2009cmH<jats:sub>2<\/jats:sub>O); <jats:italic>p<\/jats:italic>\u2009=\u20090.0001]. The median squeeze pressure significantly decreased after surgery [356\u2009cmH<jats:sub>2<\/jats:sub>O (range 137\u2013579\u2009cmH<jats:sub>2<\/jats:sub>O) vs. 329\u2009cmH<jats:sub>2<\/jats:sub>O (range 72\u2013594\u2009cmH<jats:sub>2<\/jats:sub>O; <jats:italic>p<\/jats:italic>\u2009=\u20090.005)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Subtotal fistulectomy with a sliding anoderm flap showed excellent healing rates with no postoperative deterioration of anal function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17018","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T04:07:29Z","timestamp":1716869249000},"page":"1301-1306","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Subtotal fistulectomy and sliding anoderm flap: A new sphincter\u2010sparing technique for anal fistula"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6211-0219","authenticated-orcid":false,"given":"A.","family":"Tsunoda","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Kameda Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Kusanagi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Kameda Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"581","article-title":"Total anal sphincter saving technique for fistula\u2010in\u2010ano: the ligation of intersphincteric fistula tract","volume":"90","author":"Rojanasakul A","year":"2007","journal-title":"J Med Assoc Thail."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-014-1183-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000374"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12224"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31828d2e29"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16297"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3862\/jcoloproctology.71.237"},{"key":"e_1_2_12_9_1","first-page":"A74","article-title":"Long\u2010term results of ligation of intersphincteric fistula tract for anal fistula","volume":"76","author":"Tsunoda A","year":"2023","journal-title":"J Japan Soc Coloproctol."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23342"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236199"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-11-61"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.17018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T07:51:39Z","timestamp":1719474699000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.17018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,27]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/codi.17018"],"URL":"https:\/\/doi.org\/10.1111\/codi.17018","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"type":"print","value":"1462-8910"},{"type":"electronic","value":"1463-1318"}],"subject":[],"published":{"date-parts":[[2024,5,27]]},"assertion":[{"value":"2023-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}